Establishing the diagnosis of Libman-Sacks endocarditis in systemic lupus erythematosus

CASE: A 43-year-old female with systemic lupus erythematosus (SLE) was admitted with fever and shortness of breath 1 month after aortic valve replacement. A diagnostic workup including chemistries, complete blood count, blood cultures, chest x-ray, and 2-D echocardiogram was performed to determine the etiology of her symptoms and differentiate between acute bacterial endocarditis and Libman-Sacks endocarditis. DISCUSSION: By utilizing Duke's criteria, antiphospholipid antibodies, and serial echocardiography, we were able to make a diagnosis of Libman-Sacks endocarditis. The patient was successfully treated for Libman-Sacks endocarditis and recovered uneventfully. CONCLUSION: This case highlights the challenges of making the correct diagnosis when 2 disease processes present with similar findings.